Provider Demographics
NPI:1053863670
Name:MESADIEU, RHODENA (LCSW)
Entity Type:Individual
Prefix:
First Name:RHODENA
Middle Name:
Last Name:MESADIEU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4180 SAN MARINO BLVD APT 208
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-8626
Mailing Address - Country:US
Mailing Address - Phone:561-316-7517
Mailing Address - Fax:
Practice Address - Street 1:11440 OKEECHOBEE BLVD STE 211
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8726
Practice Address - Country:US
Practice Address - Phone:561-316-7517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW136891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical